The clinical effectiveness of weight loss drugs

At a time when obesity is reaching epidemic proportions across the western world and increasing rapidly in developing countries, clinicians clearly are becoming more aware of the need to offer weight management advice and effective treatment to patients, especially those with a high risk of developing type 2 diabetes. For those patients with a BMI ≥ 30.0 kg/m(2) or for those with a BMI of 27.0 kg/m(2) with an obesity-related disease such as dyslipidaemia or type 2 diabetes mellitus, modest weight loss in the order of 5% achieved by modification of dietary intake and activity behaviour can significantly improve risk factors for obesity-related diseases and delay progression to type 2 diabetes. Unfortunately, rates of adherence with dietary-based weight management programmes are generally low and for most patients weight regain with time is common. The use of weight loss medications is recognised as a positive strategy for helping patients adhere to lifestyle advice, and has been shown to result in clinically significant and meaningful improvement of symptoms, risk factors and quality of life. Appropriate selection and use of weight management drugs requires an understanding of the benefits and risks associated with each of the available drugs. Clinical trials are ongoing to determine whether weight management interventions (including anti-obesity pharmacotherapy) will impact upon clinical outcome and life expectancy.: